RecoverRx Performance and Recovery BlogThis blog is dedicated to all things from recovery to performance. Our industry expert Physical Therapists provide evidence based information and opinions educating our readers on how to optimize their health in order to be able to overcome injuries and live the life they were meant to live!
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By Dr. Luke Greenwell, PT, DPT, CSMT, CSCS Can dry needling help my shoulder injury? Dry Needling can be a very effective treatment strategy for men and women with musculoskeletal pain including rotator cuff injuries with or without tears. What is Dry Needling?? Dry needling treatment involves insertion of solid (non-hypodermic) needles into the muscle or fascia below the skin. “Dry” refers to the fact that there is no medication in the needle. There has been plenty of research to support dry needling (also known as trigger point dry needling, intramuscular dry needling, and needling) as an effective way for Licensed Practitioners (Physical Therapists, Chiropractors, Physicians, and Acupuncturists) to:
There has been a historical misconception that dry needling is used only for patients with myofascial trigger points as a way to “release the trigger point.” However, recent evidence is out there to support other neurophysiological mechanisms for pain relief and muscle tension reduction.  In fact, we use Dry Needling in many of our patients as a way to increase muscle activation and biomechanical feedback when attempting to retrain normal movement patterns and increase strength in the injured extremity. What is the Rotator Cuff and How can it get Injured? Rotator cuff injuries including tears are some of the most common causes of disability across the globe. The rotator cuff is a group of 4 muscles (infraspinatus, teres minor, supraspinatus, and subscapularis) that in isolation can perform different movements of the shoulder but in conjunction have the main function of stabilizing the head of the humerus (ball) in the glenoid (socket) to avoid asymmetrical loading on different tissues that help stabilize the shoulder.
Rotator cuff injuries can either be traumatic (falls, weightlifting, or throwing) or chronic degeneration (small tears that add up over time). Once the rotator cuff is compromised, the normal biomechanical movement properties of the shoulder are affected and can lead to pain, weakness, and compensatory movement strategies. In many cases, strains and small to medium tears can heal with the right treatment strategies but in some cases, with large tears surgery is warranted. I won’t be covering surgical recovery cases in this article, but will mostly focus on how we utilize Dry Needling in our Rehab for our patients with rotator cuff strains or small to medium tears. How Do We Utilize Dry Needling to Treat Rotator Cuff Injuries? Let’s talk about how we address these injuries in the clinic while utilizing Dry Needling as a therapy. The most important start to our process is to develop an accurate working diagnosis of rotator cuff injury via a comprehensive shoulder evaluation. From there we are able to identify
Typically after 1 session of dry needling (this can involve multiple needle insertions to multiple muscles) we do see a very immediate change. With that being said, we typically need multiple sessions over the course of a couple weeks. We like to educate that there will be some soreness in the areas where we see a significant response (known as a muscle twitch response). What do I need after I receive Needling treatment? After the dry needling is performed to the identified areas, we can use the rest of the session to focus on:
This Strategy Works! It’s a tried and true strategy that has worked for thousands of patients we have seen for shoulder pain and although every patient is different, we find this system to be very effective in helping patients recover from rotator cuff injuries. Our 3 step process of Recover (from painful limitations), Rebuild (functional movement patterns) and Redefine (future strength and performance) could never be more true for our patients with rotator cuff injuries. Check out this videos of a Dry Needling Technique: www.youtube.com/shorts/cfXC0UI6xGY. To see even more, subscribe to our YouTube Channel and Follow us on social media @recoverrxpt. If you would like more information on our approach to treating shoulder pain in addition to rotator cuff injuries, please feel free to reach out to us via email at info@recoverrxpt.com. Thanks again for checking in and be on the lookout for our next Badass Blog! Use Every Setback As A Comeback! -Dr. Luke Sources:
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What is intermittent fasting?
The health and wellness landscape is certainly full of trends, and one nutrition strategy that has gained a lot of attention recently is intermittent fasting. Intermittent fasting, or “IF”, is defined as when a person alternates between periods of eating and periods of fasting. The terms “patterns” or “cycles” may also be used to describe this almost rhythmic type of diet. Using intermittent fasting as a tool does not necessarily mean you are cutting your caloric intake way down, but rather you are consuming your calories in designated windows of time, usually with longer stretches between consumption, and these windows are consistent day to day or week to week. For example, you may choose to only eat between the hours of 9am and 5pm each day. Some methods of this type of diet suggest you decrease caloric consumption on certain days, while also adhering to specific eating windows 
What are the potential health benefits of IF?
The belief behind this approach to nutrition is that your body may become satisfied with smaller portions, and cravings for less healthy foods may also decrease. The outcome of IF may be weight loss, which can also help lower the risk of diabetes, sleep apnea, and some types of cancer. According to Mayo Clinic, some research suggests that intermittent fasting may be more beneficial than other diets for reducing inflammation and conditions such as Alzheimer’s disease, arthritis, asthma, multiple sclerosis, and stroke. What are the potential risks? Intermittent fasting is not recommended for everyone. Those who should avoid this type of diet include pregnant or nursing women, people with a history of eating disorders, people with risk of hypoglycemia, and those with certain chronic diseases. It is always important to consult with your healthcare provider before beginning any dietary changes. What are the different types of IF? According to Cleveland Clinic, there are a few different approaches to intermittent fasting, which is a benefit of the diet overall - there is no one-size-fits-all way to incorporate it into your life. Below are some ways this type of diet is utilized:
How do you know if IF is right for you?
Just like no two people are the same, no two diets are either. Everyone’s lifestyle, preferences, and resources are different, so intermittent fasting may or may not be a good strategy for you. With several methods of IF, it’s important to be open to some trial and error if you decide to give it a shot - one method may work and feel much better than others. Consulting your healthcare provider and being open to trying something new when it comes to your approach to nutrition are great ways to start exploring this diet.
What is NEAT?
Non-exercise activity thermogenesis (NEAT) is the energy your body uses to do everything other than sleep, eat, or formal exercise. In other words, it is the calories that are burned by the movements you make by going through your daily routine, not including those expended at the gym. There are a vast number of activities that fall into this category, including typing at a computer to walking around the grocery store to performing yard work. While some types of movement or activities you do during the day may not seem significant, NEAT can have a big impact on your metabolic rate and overall health. 
The Benefits of NEAT
Research shows that incorporating more informal movement into your day - like biking to work or taking a phone call while walking around the block - could be a critical piece to the weight management puzzle and also help you stay more mobile, agile, and feel better overall. Higher levels of NEAT are also connected with lowered risk of metabolic syndrome and cardiovascular events. A study in 2018 showed that a low level of NEAT is associated with obesity, and that a higher level of this type of physical activity enhances lifestyle. People who report having a moderate-to-high level of activity throughout the day outside of formal exercise also report feeling more energetic and an improvement in mood versus when they experience days of low levels of physical activity. From disease prevention to feeling good both physically and mentally, it’s clear that NEAT is a useful tool. Ways to Boost Your NEAT (and Still Be Productive)
Whether you have a goal to lose body weight, prevent cardiovascular disease, or feel more energetic, NEAT could be your ticket to get there. Little choices and small steps taken repeatedly can add up to big achievements when it comes to your health. There’s no one-size-fits-all approach to wellbeing - find what works for you and your health journey and stick to it!
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AuthorsDr. Luke Greenwell, Dr. David Bokermann, Dr. Sarah Greenwell, & Dr. Ariel Sernek are Performance Based Physical Therapists with extensive backgrounds in treating the injured athlete. At RecoverRx, they are passionate about returning people to the sports & activities they love. Check out more about them by visiting our About Us page. Categories
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